Congressional lawmakers are dealing with difficult arithmetic as they hammer out a finances plan to finance President Donald Trump’s agenda.
Republicans must liberate roughly $4 trillion to pay for renewing Trump’s 2017 tax cuts, which expire on the finish of the yr. Trump has vowed to not contact the most costly authorities applications, together with Medicare and Social Safety.
He’s been much less clear about his plan for Medicaid.
On Wednesday, he endorsed a Home GOP plan that cuts at the least $880 billion from, very doubtless, Medicaid — the federal-state medical health insurance program for People with low incomes or disabilities.
As my colleague Phil Galewitz reports, adjustments to increase Medicaid have change into entrenched in most states — and their budgets — over the previous decade. Hospitals, which not solely deal with but additionally make use of loads of People, are reaching out to Congress with issues.
Medicaid can be common. A January KFF ballot discovered that about 3 in 4 People view this system favorably. So Republicans must be strategic about cuts.
However first, let’s again up. What’s Medicaid? My colleague Sam Whitehead and I published a useful explainer this week.
Medicaid, which turns 60 this summer time, was created as a part of President Lyndon B. Johnson’s “Nice Society” technique to assault poverty together with Medicare, the federal medical health insurance program for these 65 and older.
Greater than 79 million individuals obtain providers from Medicaid or its intently associated Youngsters’s Well being Insurance coverage Program. That’s about 20% of the nation’s inhabitants.
About 40% of all kids are coated by Medicaid or CHIP. Medicaid additionally pays for 4 in 10 births and covers prices of caring for greater than 60% of nursing dwelling residents.
State and federal spending on this system reached $880 billion final yr.
Again in Washington, Phil writes that the GOP is contemplating just a few methods to shrink Medicaid.
They may cut back how a lot cash the federal authorities sends to states, leaving state leaders to determine whether or not and tips on how to plug finances holes.
One concept Republicans are brazenly speaking about is imposing work necessities. Most adults enrolled in Medicaid are already working or most likely could be exempt as a result of they’re at school, are caregivers, or are disabled.
However, as Sam and I report, state experiences with work requirements present they make it tougher for even eligible individuals to get protection.
On the coronary heart of all of it are key questions concerning the function of presidency in individuals’s well being: How huge ought to the U.S. medical insurance coverage security web be? Who deserves authorities help?
And, maybe most urgently, the place will those that may lose Medicaid go for protection?
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